Epstein: "Public And Private Competition In Health Care"

Public And Private Competition In Health Care

Richard A. Epstein

Forbes.com

July 7, 2009

Today, I can see no optimistic scenario for the future of American health care. The political pressures all point toward greater government involvement in an area that has been distinguished by a long list of government failures. Medicare and Medicaid have yet to find out how to give away health care at below-market prices without spurring unquenchable demand. Markets have traditionally performed this function through rationing by price.

Of all the bad "market" ideas now in vogue, perhaps the most insidious calls for the creation of a new public entity to compete with private health care providers in a complex market. Right now a multitude of small firms coexist with such huge operations as Aetna, Blue Cross/Blue-Shield, Cigna, United HealthCare, and WellPoint. But does this medley of firms suffice? In a recent Wall Street Journal column, Robert Reich, a former Secretary of Labor, suggests that the answer is no. Reich thus comes out "swinging" in support of this public competition.